Findings: On axial (Figure A) and sagittal (Figure B) black blood DIR FSE images, the patient is noted to have a dilated ascending aorta, which measures approximately 48 mm in diameter. Steady state free precession is a relatively newer MR pulse sequence that provides good homogeneity of the bright blood pool signal and confirms the aortic dilatation noted on black blood images (Figures C and D). On cine bright blood MR using fast gradient echo imaging, a distinctive systolic flow jet (Figure E, arrow) is noted which arises from the posterior aortic valve into the ascending aorta. This moderate to large jet is consistent with moderate to severe aortic stenosis. No diastolic jet to suggest aortic insufficiency was seen (not shown). On cine bright blood phase contrast imaging at the level of the aortic valve, the aortic valve orifice is noted to be lens shaped (Figure F, arrowheads). Contrast-enhanced three-dimensional MRA (Figure G) confirmed the dilated ascending aortic root and absence of an aortic dissection or coarctation.

Findings: On axial (Figure A) and sagittal (Figure B) black blood DIR FSE images, the patient is noted to have a dilated ascending aorta, which measures approximately 48 mm in diameter. Steady state free precession is a relatively newer MR pulse sequence that provides good homogeneity of the bright blood pool signal and confirms the aortic dilatation noted on black blood images (Figures C and D). On cine bright blood MR using fast gradient echo imaging, a distinctive systolic flow jet (Figure E, arrow) is noted which arises from the posterior aortic valve into the ascending aorta. This moderate to large jet is consistent with moderate to severe aortic stenosis. No diastolic jet to suggest aortic insufficiency was seen (not shown). On cine bright blood phase contrast imaging at the level of the aortic valve, the aortic valve orifice is noted to be lens shaped (Figure F, arrowheads). Contrast-enhanced three-dimensional MRA (Figure G) confirmed the dilated ascending aortic root and absence of an aortic dissection or coarctation.